Library

The heaven and earth constitute a space of continuous tilting and pressing; yin and yang are qi that rub against and激荡 (agitate) each other; the Five Phases are numbers of mutual dependence and latent potential; all things are phenomena of constant推移 (shifting); the four seasons are laws of alternating succession. This is called daily renewal, this is called ceaseless motion. Without restraint, there can be no growth; without overcoming, there can be no recovery, and then the mechanism of heaven and earth would cease, and the species of beings would perish. If its mechanism is not激 (stimulated), it will not move; if it does not move, it becomes dull and unresponsive, and yin, yang, and the Five Phases accumulate in places of uselessness. Would not heaven, earth, and all things suffer destruction and damage? The *Neijing · Liù Wēi Zhǐ Dà Lùn* (Great Treatise on the Six Subtle Principles) states: Below Xiāng Huǒ (Ministerial Fire), Shuǐ Qì (Water Qi) assumes control; below the position of Water, Tǔ Qì (Earth Qi) assumes control; below the position of Earth, Fēng Qì (Wind Qi) assumes control; below the position of Wind, Jīn Qì (Metal Qi) assumes control; below the position of Metal, Huǒ Qì (Fire Qi) assumes control; below Jūn Huǒ (Monarch Fire), Yīn Jīng (Yin Essence) assumes control. When there is excessive flourishing (Kàng 亢), harm ensues; when there is assumption of control (Chéng 承), there is restraint (Zhì 制); with restraint, there is generation and transformation (Shēng Huà 生化), manifesting externally as prosperity and decline; when harm occurs, disorder prevails, and generation and transformation become major diseases. The terms "below" and "assume control" are used here to describe the steps of the Six Qi; thus, the wording is necessarily so. However, if we investigate the substance of all things, what is meant by "below" is not something external to the substance acting downwards, but rather this Qi naturally exists within the substance itself, blending seamlessly. What is meant by "assume control" is not attaching from the outside, but existing within. Why? Because there is not a single thing in the world that does not contain the Five Phases, nor a moment in the four seasons that lacks the Qi of the Five Phases; there are only differences in quantity and degrees of flourishing and decline. If operation deviates slightly, the victorious phase becomes excessive, and the defeated phase suffers harm. The reason it does not ultimately result in harm is because of restraint. This restraint is not applied after excess has already occurred. Fire is restrained by Water, so Fire naturally has containment and does not overstep; Water is restrained by Earth, so Water naturally has prevention and does not flood; Earth is restrained by Wood, so Earth naturally has movement and does not stagnate; Wood is restrained by Metal, so Wood naturally has pruning and does not grow wildly; Metal is restrained by Fire, so Metal naturally has refinement and does not become stubborn. "Assuming control" implies hidden restraint before the event, so that one need not wait for excess to cause harm; harm is eliminated imperceptibly. As for the term "restraint," the world generally believes it means suppressing excessive vitality, not realizing that restraint actually assists the mechanism of generation. When Wood is restrained by Metal, it does not overflow, and its force concentrates on Fire; when Fire is restrained by Water, it does not dissipate, and its essence gathers in Earth. This refers to "generation." If Wood is excessive and cannot generate Fire, it is due to dampness; restrained by Metal, Wood becomes dry, and Fire is formed. If Fire is excessive and cannot generate Earth, it is due to dryness; restrained by Water, Fire becomes moist, and Earth is formed. This refers to "transformation." Restraint is how all things begin and end; it prevents harm after excess and initiates generation. Is this not the profound mystery of the opening and closing of Heaven and Earth, and the unfathomable nature of Yin and Yang? Understanding this principle allows one to clearly grasp the mechanisms of disease Qi's victory and retaliation, and the way of harmonizing therapeutic flavors and properties. I have carefully collected the famous discourses of former sages, along with my own humble insights, regarding the principles of Yun Qi (Luck/Qi Movement), variations in disease mechanisms, and essentials of treatment methods, listed below for review.

Considering the changes of the four seasons, Five Phases, and Yun Qi, the mechanism is very subtle. In the harm of excess: Wood excess harms Earth; if Earth is harmed, Water acts recklessly and Fire extinguishes, causing Earth to lose its source of generation. Fire excess harms Metal; if Metal is harmed, Wood grows wild and Earth weakens, causing Metal to lack its root of nourishment. Earth, Metal, and Water follow similar patterns. This harm of excess harms others. There is also harm of excess that rebounds upon oneself. Shi Zaizhi stated: The classics say, when Heavenly Fire descends, Lung Metal follows upward; Bai (White/Metal) takes effect, and grasses suffer. When Dryness descends, Liver Qi follows upward; Cang (Green/Wood) takes effect, and Earth suffers. According to normal controlling relationships, Fire arriving causes Lung disease, and Metal arriving causes Liver disease. Now, with Heavenly Fire descending, Metal follows the Heavenly Qi, and White takes effect, so disease arises in the Liver. With Heavenly Metal descending, Wood follows the Heavenly Qi, and Green takes effect, so disease arises in the Spleen. By analogy, when Jueyin governs the year, Spleen Qi follows upward, and Water suffers; when Taiyang governs the year, Heart Qi follows upward, and Metal suffers; when Taiyin governs the year, Kidney Qi follows upward, and Fire suffers. All these can be known. This dignity of Heavenly measures is unique. The classics state: Heaven can control colors because it can overcome what conquers itself, preventing harm. Regarding Earthly governance, it is the normal气化 (Qi transformation), varying with symptoms. Only the signs of victory and retaliation differ, sought according to the abundance or scarcity of Qi. Disease caused by Victory Qi is mild; disease caused by Retaliation Qi is severe. Victory involves the unconquered accepting control; Retaliation involves seeking revenge. These must be understood. For example, if Wood is diseased due to restraint by Lung Metal, it is merely excessive Lung Qi invading the Liver, causing dizziness, itching, deafness, chest pain, and heaviness. But if Wood's transformation is excessive, and Liver Qi acts recklessly, severely harming the Spleen, Metal must rescue, and the pathogen injures the Liver, causing heaviness, vexation, chest pain radiating to the back, and fullness/pain in the hypochondrium radiating to the lower abdomen. Thus, the classics mention correspondence to the Star Taibai (Venus), indicating Metal's retaliation. This is Shi Zaizhi's argument. "Victory" refers to the harm of excess; "Retaliation" refers to the restraint of assumption. The classics say: Wind injures the Liver, Dryness overcomes Wind; Heat injures Qi, Cold overcomes Heat; Dampness injures Flesh, Wind overcomes Dampness; Dryness injures Skin/Hair, Heat overcomes Dryness; Cold injures Blood, Dampness overcomes Cold. These are Victory Qi. It also says: Wind excess causes movement; Heat excess causes swelling; Dryness excess causes dryness; Cold excess causes edema; Dampness excess causes loose stools; severe cases cause water retention and edema. These are signs of Victory. It also says: Where there is surplus, deficiency follows; where there is deficiency, surplus follows. This is the mechanism of Retaliation. It also says: The fluctuation of victory and retaliation cannot exceed limits; their coming and going cannot surpass bounds; their use of ascending and descending cannot be absent. It also says: When Qi is in excess, it controls what it normally conquers and insults what normally conquers it. When Qi is deficient, what normally conquers it insults and exploits it, and what it normally conquers lightly insults it. Insulting leads to receiving pathogens; receiving pathogens is due to lack of fear. This is the general rule of victory and retaliation. Why? If Wood excess harms Earth, Earth Qi has nowhere to vent and concentrates on Metal. If Earth excess harms Water, Water Qi has nowhere to use and accumulates force in Wood. Metal retaliates against Wood, allowing Earth Qi to extend. Wood retaliates against Earth, allowing Water Qi to extend. Moreover, today's excess is yesterday's restraint, and today's restraint becomes tomorrow's excess. Restraint without end leads to excess again. The classics say: Insulting leads to receiving pathogens. Shi Zaizhi said: Severe retaliation disease occurs because Retaliation Qi accumulates strength over time, while Victory Qi is exhausted through venting. Thus, the classics say: When Victory arrives, the Retaliation Qi lies dormant. When Victory arrives, Retaliation follows; when Retaliation ends, Victory returns. There is no fixed number. Thus, the classics further say: Do not aid Victory, do not assist Retaliation. Treating Victory Qi requires pacifying the dormant Qi to prevent Retaliation Qi from insulting back. Alas! The teachings of the sages are profound. This harm of excess rebounding upon oneself is called "burning oneself by not sheathing the sword." Restraint and Retaliation are the substantial manifestations of assumption and restraint. There is also the virtual manifestation of assumption and restraint. The substantial can generate and transform; the virtual cannot. Why? In the substantial case, Wood excess is controlled by Metal, which actually generates Metal Qi for retaliation. Metal excess is controlled by Fire, which actually generates Fire Qi for retaliation. In the virtual case, Wood reaches extreme excess and presents an illusion of Metal. This Metal cannot control Wood but instead severely harms Earth. Metal reaches extreme excess and presents an illusion of Fire. This Fire cannot control Metal but instead severely harms Wood. Liu Hejian said: Sores and ulcers belong to Fire, but those rotting and discharging pus/water are like grains, fruits, meat, and vegetables rotting under extreme heat into sewage. Rotting is the transformation of Water. The principle of the Five Phases is that at extremes, the conqueror comes to restrain. Thus, extreme Fire transforms into Water. He also said: All sudden stiffness, limb pain, twisting, interior urgency, and tendon contraction belong to Wind. Dryness/Metal governs tightness and shortening. Wind-Wood disease presenting Dryness-Metal transformation is due to excess causing harm and assumption bringing restraint. Furthermore, Wind overcomes Dampness to create Dryness. The entire *Yuan Bing Shi* discusses this. This is the virtual aspect of assumption and restraint. Here, assumption and restraint are excess and harm, not generation and transformation. Yi Lao's *Bao Ming Ji* calls this the virtual image of mixed transformation. Liu claimed: The classics say "excess causes harm, assumption brings restraint," meaning extreme excess assumes the transformation of its conqueror to restrain the severity. Like using fire to smelt metal; extreme heat turns it to water. The principle of Five Phases: subtle cases follow original transformation; severe cases assume the ghost/killer phase. Thus, mistaking the virtual image of extreme excess for the practical use of assumption and restraint is erroneous. Recognizing similarity as truth is indeed absurd! (Liu's discussion concerns the virtual aspect of assumption/restraint; this critique is most penetrating, unseen since antiquity.)

In treating diseases, for the substantial aspect of assumption and restraint, one must pacify the dormant Qi to achieve preventive efficacy; for the virtual aspect, one must observe the origin to gain true wisdom. The mutual generation and restraint of the Five Phases form all things and yield all methods. Zhang Yin'an said: Dates are yellow and sweet, fruits of the Spleen. Fruits at the tips of Wood that become Heart fruits illustrate the way of generation (Wood generates Heart Fire). Fruits at the tips of Wood that become Spleen fruits illustrate the way of restraint (Wood restrains Spleen Earth). All things born of heaven and earth feel the generation and transformation of the Five Movements and Six Qi. Understanding Yin-Yang generation and control allows the nature of all things to be used to generate and transform the Qi of the Zang-Fu organs. Thus, peaches are Lung fruits; pits benefit Liver blood. Apricots are Heart fruits; pits benefit Lung Qi. All follow the logic of restraint and transformation. The *Bencao Shu* entry on Da Huang cites Lu Bu Yuan: Da Huang is extremely bitter and cold, seemingly obtaining the correct transformation of Cold Water, yet rising heat produces bitterness, and bitterness moves downward—is this not contradictory? The *Cantong Qi* says: Five Phases control each other, becoming parents to one another. The *Suwen* says: Restraint leads to generation and transformation. Thus, the substance of the Five Phases uses control as function. That which moistens and flows down is the function of that which flares up. Therefore, for any Heart dysfunction producing phlegm-disease, using bitter substances of the same category to enter via Xun (obedience/subtlety) cannot manifest its function and restore normalcy. This view aligns with the *Liuyuan Zhengji*: The functions of the Six Qi return to what they do not conquer to transform. Thus, Taiyin's Rain Transformation applies to Taiyang; Taiyang's Cold Transformation applies to Shaoyin and Shaoyang; Shaoyin/Shaoyang's Heat Transformation applies to Yangming; Yangming's Dryness Transformation applies to Jueyin; Jueyin's Wind Transformation applies to Taiyin. Where there is application, there is reception. Taiyin's Rain Transformation applying to Taiyang means Taiyang's Cold Water function must receive Taiyin's Rain Transformation to complete its use; conversely, Taiyin's Rain Transformation must receive Taiyang's Cold Water reception to complete its use. Thus, restraint is how the Six Qi complete themselves and things. Lu citing the *Cantong Qi* instead of the *Neijing*, seeking far sources near home, is not the way to guide students. This is the nature of living things.

Regarding prescription formulation, Ke Yunbo discussed the rationale of Sishen Wan: From cockcrow to dawn, it is Heaven's Yin, Yang within Yin. Yang Qi should arrive but does not; empty pathogens remain, causing diarrhea at dawn. Causes include: 1. Spleen deficiency failing to control Water; 2. Kidney deficiency failing to move Water. Thus, Ershen Wan uses Gubuzhi (Psoralea Fructus), pungent and dry, as sovereign to enter Kidney and control Water; Rou Doukou (Nutmeg), pungent and warm, as assistant to enter Spleen and warm Earth; pills made with Jujube flesh, pungent-sweet dispersing to generate Yang. 3. Mingmen Fire decline failing to generate Earth; 4. Shaoyang Qi deficiency failing to initiate growth. Thus, Wuweizi San. Wuweizi (Schisandra Berry), sour and warm, as sovereign to gather dissipating Fire in Kan Palace; Sheng Huo Qi Sheng generates Qi to cultivate Earth; Wuzhuyu (Evodia Fruit), pungent and warm, as assistant to smooth Liver Wood's desire to scatter, opening paths for Water Qi generation to serve Spring growth. Though etiologies differ, symptoms are the same: all involve Water excess causing harm. Ershen Wan is an assumption-restraint formula; Wuweizi San is a generation-transformation formula. Different theories, same usage; they can be used interchangeably or combined. Combined as Sishen Wan, it is a restraint-generation formula. Restraint generates transformation; chronic diarrhea heals. This method is based on the principle of Five Phase assumption, restraint, generation, and transformation. Such discussions by past sages cover luck, material nature, disease mechanisms, and methods comprehensively.

My humble insights from reading discuss the substance/function of Five Phases and the auspicious/inauspicious, slow/fast nature of disease mechanisms. Liver governs East Wind-Wood; its substance is moist, containing Earth Qi. Wood controls Earth, thus Earth serves it. Its nature is dispersing, the upright Qi of Wood. Its function is dryness; dampness becomes dry with wind, representing Metal Qi. Metal controls Wood; Wood contains Metal Qi, restrained by Metal to prevent excessive dispersion. Heart governs South Fire-Heat; its substance is dry (things must be dry to catch fire, and harden in fire), representing Metal Qi. Fire controls Metal, thus Metal serves it. Its nature is hot, the upright Qi of Fire. Its function is steaming; things forced by fire become moist, representing Water Qi. Water controls Fire; Fire contains Water Qi, restrained by Water to prevent excessive heat. Spleen governs Central Wet Earth; its substance is muddy/moist, representing Water Qi. Earth controls Water; Water is Earth's servant, serving Earth. Its nature is calm/still, the upright Qi of Earth. Stillness easily stagnates, needing Wood Qi to disperse. Earth is the归宿 (destination) of all things, possessing four Qi, urgently seeking help from Water and Wood. Why? Earth must not be dry nor stagnant. Thus, Spleen's function is movement, representing Wood Qi. Lung governs West Dryness-Metal; its substance is tough/clean, representing Wood Qi. Its nature is clear/descending, the upright Qi of Metal. Its function is fierce/severe; summer heat/fire frightens people, so does Metal; Metal contains Fire Spirit. Fire has light; Metal has light too. Kidney governs North Cold Water; its substance is flowing, representing Fire Qi. Its nature is sinking/lowering, the upright Qi of Water. Its function is moist/warm, representing Earth Qi. Thus, within the Five Phases, each contains the Five Phases, self-sufficient without external seeking. This is the natural number of heaven and earth generating each other, the constant norm. Balanced, unbiased, deviation leads to disease. Deviation means self-disease exploited by what conquers it, or self-disease exploiting what it conquers. Both exist. Past scholars conflated their auspicious/inauspicious and slow/fast natures. I analyze: Self-disease exploited by the conqueror is uncertain in outcome but slow in progression. Self-disease exploiting the conquered is fast and fatal. Why? Self-disease normally allows exploitation (smooth/natural); self-disease exploiting others is reverse/abnormal. Smooth vs. Reverse depends on Deficiency of Righteous Qi vs. Excess of Pathogenic Qi. In Deficiency: Spleen Earth deficiency leads to Liver Wood excess; Heart Fire deficiency leads to Kidney Water excess. Liver/Kidney have no pathogen, no intent to attack Spleen/Heart. It is merely that when one Zang is deficient, another overflows, creating mutual suction. Spleen deficiency fails to transport, causing Wood Qi fullness; Heart Qi fails to rise, causing Water Qi cold coagulation. The disease is in the deficient Zang, not the attacking Zang. Outcome is uncertain because if Qi is slight, generation power is slight; medication can restore it without purging the attacker. Treatment is easy, requiring no complex maneuvering. Only when the deficient Zang's Qi is exhausted, and generation power ceases, is it hopeless—hence "slow." In Excess: Liver Pathogen Excess attacks Earth, regardless of Spleen deficiency. Kidney Pathogen Excess attacks Fire, regardless of Heart deficiency. Attack leads to transmission; seven transmissions lead to exhaustion of Life Qi. Death is predictable at initial transmission. Why? The diseased Zang normally shouldn't attack others. If it can, Pathogen is strong, and Original Qi is exhausted, unable to control itself, letting Pathogen run rampant. If Original Qi remains, it controls the Pathogen. Exhaustion of Original Qi cuts off the source of life; the conquered Zang loses support, making transmission easy. E.g., Liver Pathogen Excess: Liver Righteous Qi cannot generate Fire, weakening Earth's transformation source. Liver Pathogen presses, no rescue. After transmitting to Spleen, Liver-Spleen combine, Pathogen strengthens, Righteous Qi weakens, momentum like splitting bamboo. Initially days per Zang, then one day per Zang, or multiple Zangs in a day. At initial transmission, transformation source is cut; tonification/purging is futile. Hence "fast and fatal." Why? Pathogen Excess gains maternal support. Liver carrying Water Pathogen attacks Earth, blocking Fire generation; Spleen carrying Fire Pathogen attacks Water, blocking Metal assistance. Same mutual attack, yet outcomes vary vastly. Clinicians must strive diligently. Yuè Rén (Yue Jingyuan) and Zhòng Jǐng (Zhang Zhongjing) discussed treating disease before onset: "Seeing Liver disease, first solidify Spleen." This is urgent prevention before transmission. Urgent prevention means suppressing Wood excess, supporting Earth deficiency, utilizing Fire Qi to guide Wood's exit and cultivate Earth's source. Methods combine attack and tonification, complex maneuvering, such as separating two/three layers, draining South, supplementing North. Skilled physicians toil for this. Xue Lizhai and Zhāng Jǐngyuè often said: "Tonify Righteous Qi, Pathogen leaves spontaneously." This applies to self-deficiency exploited by others. Etiology is self-deficiency; originally no pathogen. Thus, directly tonify the palace, no need to purge.

I also discussed the meanings of "Cold treat with Heat, Heat treat with Cold," "Mild treat oppositely, Severe treat similarly," and "Fake treat reversely." Former sages said: Excess Heat broken by Bitter-Cold; Deficient Heat removed by Sweet-Warm. Using Bitter-Cold follows "Heat treat with Cold, Mild treat oppositely." Using Sweet-Warm follows "Fake treat reversely." Also, Yin Excess repelling Yang, Yang Excess repelling Yin: treat the primary cause, subdue the origin; take Cold medicine hot, or Hot medicine with Cold assistants. This is "Severe treat similarly," i.e., counter-assistance. Among these, "Opposite" is most obvious; "Similar" was detailed by former sages. "Fake treat reversely" lacked firm theory and was often confused with "Severe treat similarly." Presuming ignorance, I briefly discuss...